Payers, TPAs & Insurers

The Bridge Between
Care and Coverage.

A unified ecosystem connecting Payers and Providers. Stop relying on dirty data and manual claims—automate your network with a Provider-Native OS.

THE CHALLENGE

We are flying blind
on claims data.

Still running your network on spreadsheets and portals? It's time to automate with Mazecare.

The Black Box

You have zero visibility into clinical data until the claim arrives weeks later. You are paying for treatments without knowing if they were truly necessary.

The Admin Waste

You are spending millions manually processing simple GP claims that should be auto-adjudicated instantly. Your skilled staff are stuck doing data entry.

The Provider Friction

Your providers hate your portals. They want a system that integrates insurance checks directly into their daily workflow, not another login.

Sounds familiar? We got you.

Core Capabilities

The First Provider-Native Payer Engine.

We don't just process claims; we connect you directly to the provider's workflow for real-time control and clean data.

Finance & Insurance

  • Auto-Adjudication Rules Engine
  • Insurance Product & Plan Builder
  • Fraud, Waste & Abuse Detection
  • Direct Provider Payments

Operations Engine

  • Provider Network Management
  • TPA Contract Control
  • Member Eligibility API
  • Utilization Review

Clinical Core (Data Access)

  • Granular ICD-10/SNOMED Data
  • Real-Time Clinical Vitals Access
  • Digital Medical Records
  • Outcome Tracking

Patient Engagement

  • Member Mobile App
  • Telehealth for Members
  • Health Wellness Programs
  • Digital ID Cards
The Challenger Edge

We Solve the "Last Mile" Problem.

01
Source Control

We Own the Endpoint

Traditional claims software sits in your office. Mazecare sits on the Doctor's desk. We control the data input quality at the source.

02
Fraud Prevention

Real-Time Intervention

Flag expensive procedures, outliers, or fraud before they happen, not 30 days later when the money is gone.

03
Population Health

Smart Health Ready

Ideal for Governments and HMOs launching population health initiatives. We help you track health outcomes, not just receipts.

Tangible Impact

ROI by the Numbers.

60% Lower Admin Costs

Slash manual processing overheads.

90% Auto-Adjudication

Process clean claims instantly.

100% Data Transparency

See clinical data behind every dollar.

15% Leakage Reduction

Stop fraud and abuse in real-time.

Faster Settlements

Pay providers quicker, improving relations.

Better Risk Models

Use granular data to price policies better.

Migration & Onboarding

Connect Your Network, Fast.

We integrate with your core policy admin system via API. No need to migrate your master database.

"By connecting directly to the clinic's OS, we reduced claim processing costs by 60% and eliminated the need for manual guarantee letters. The providers love it, and so do we."

— Director of Innovation, Regional Insurer

Trust & Transparency

Data Sovereignty
& Compliance.

Your member data never leaves your control. We integrate securely with your core infrastructure.

Regional Compliance

  • Regional Diagnosis Coding (ICD-10 AM/WHO)
  • Local Currency & Tax Logic
  • Govt Health Interface Ready

Global Security

  • Audit Trails
  • Data Residency
  • Secure API

Ready to Transform Your Healthcare Operations?

Join thousands of providers delivering exceptional patient experiences with Mazecare. Start your journey today.